View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Analysis and Use of Core Data Sets 0920-0853
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0853 Performance Measures Reporting Tool Att5a_PMReportingTool.xlsx Yes Yes Fillable Fileable
Form and Instruction 0920-0853 Emergency Department Visits Reporting Form Att6a_AIRS ED Visits Reporting Form.xlsx Yes Yes Fillable Fileable
Form and Instruction 0920-0853 Hospital Discharge Reporting Form Att7a_AIRS HD Reporting Forms.xlsx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

90 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 90 0 90 0 0 0
Annual IC Time Burden (Hours) 105 0 105 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
PM Reporting tool Instructions Att5c_Instructions for PM Reporting Tool.docx 03/02/2020
ED Reporting example Att6b_AIRS ED Visits Reporting Example.xlsx 03/02/2020
HD reporting example Att7b_AIRS HD Reporting Example.xlsx 03/02/2020
PM Comparison Table Att8_PM Comparison Table.docx 03/02/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.